Avoiding adoption pitfalls II: Problems with attachment

Regardless of the process that you use to adopt, adoptions can still go wrong if the child doesn’t attach or exhibits profound behavioural problems. Internationally, this is the adoption-related issue that receives the most attention, especially in first world countries where adopted children are often older or where children have been adopted from hugely deprived environments, such as orphanages in Russia or China. These children sometimes have difficulty attaching to their adoptive families or find it hard to adjust to their new lives. Adoptive parents often find this challenging, so much so that a recent study by Reuters International exposed a number of families in America who have chosen to “re-home” their adoptive children, ostensibly because they were “difficult” or behaving “badly”.

When my husband and I decided to adopt, a friend in England told us we were ruining our lives. Thankfully, he was wrong, our daughter could not be more delightful. But I could see where he was coming from—he knows at least one family in the UK who are living a nightmare because of their children, who just happened to be adopted.

So should this make you think twice about adoption? Well in truth, any child, biological or adopted, can exhibit behavioural problems but attachment can be a real issue in adoption, especially for older children. However, there is hope. Reactive attachment disorder (the most severe version of attachment disorder) is relatively rare and can be overcome with expert help, while other, less extreme versions of attachment problems are more easily combatted if you follow guidelines provided by social workers and Places of Safety.

Here are six things that you can do to safeguard your family against potential challenges with attachment.

Visit your child before you take her home

It is hugely tempting as a new adoptive parent to scoop your child up at the first meeting and take her home with you. This is particularly appealing if your child is not in the most nurturing environment. But, even if the Place of Safety is not ideal, it is your child’s home and in many cases, the only home and the only caregivers that she has ever known. While not all Places of Safety require you to visit your child before you take her home, this “courtship period” is extremely important for your child’s ability to attach. Social workers will tell you that you need to visit “until…” Small children may bond quite quickly but the older your child is, the more introverted she is, or the more abusive her history is, the longer she may need to get comfortable with you and your family before you move her permanently into your home. Trust your child’s social worker and caregivers and wait for signs of acceptance from her before you take the big step of taking her home.

Follow the guidelines provided by your social worker

When we took our daughter home, our social worker told us that my husband and I needed to do all of her bathing and feeding for her first month at home. She explained that it would make a huge difference to our child’s bonding process. I have heard many adoptive families complain that this is impractical (especially if they aren’t able to secure maternity leave) but we took the advice very seriously and I am very glad we did, it was a very special experience for us and our little girl attached very quickly. Our own story has taught me that it is worth doing whatever you can to ensure that your child recognises you as her mom and dad. And, in the end, it is a small sacrifice to make given the relatively short time you have to build the foundations of your relationship.

Be aware of the dramatic change in your child’s environment

Most children that come out of a Place of Safety are used to noise and activity—they haven’t done anything alone. But in many cases (especially if the child is an effective “first born” in your family), she arrives home to a beautiful, pristine and very quiet house. Your child’s first night in a new home may also be her first experience of sleeping alone and in silence. It might seem counter-intuitive when you have just bought the best and most beautiful things for your little one’s new room but, at least initially, she may prefer a rudimentary camp cot at the foot of your bed (or in one of her new sibling’s rooms) to sleeping on her own. So, give her some noise and company for a period of time and let her move into her own bedroom when she is ready.

Use tried and tested techniques for bonding with your child

While it is important to take your child’s age and receptivity into account (and to obtain expert input if your child is struggling to attach), consider using some of these techniques when bonding with your adopted child:

Skin to skin.

Wearing your child.

Breast-feeding (speak to your social worker to get advice and assistance if you are considering breast-feeding).

Co-sleeping.

Touch—strokes, cuddles and kisses.

In addition, make time for intimacy, sharing and play, and to laugh with, talk to and listen to your child. And, be sure to respond to her needs as quickly as possible, especially in the first couple of months.

Get a professional assessment

Our daughter had amazing medical care at the Place of Safety where she spent the first five months of her life. But, we still took her for a full medical assessment when we brought her home, just to be sure that none of her little health niggles were anything serious. Similarly, if we had suspected any attachment problems, we would have taken her for an assessment with an attachment specialist too. Your fears may be completely unfounded but professionals agree that if there is an attachment problem, early detection and having a treatment strategy (developed by an expert) is vital for dealing with it in the most effective way.

Educate yourself about attachment disorder and the implications of your child’s history

Attachment problems occur when children have been unable to consistently connect with a parent or primary caregiver. They fall on a spectrum, from mild problems—that are easily addressed—to the most serious form, known as reactive attachment disorder (RAD).

Reactive attachment disorder is an uncommon but serious condition in which a child or infant doesn’t establish a healthy attachment with his or her parents or caregivers. It may develop if a child’s basic needs for comfort, affection and nurturing aren’t met or where the child has had multiple impermanent or unreliable caregivers.

Attachment disorder presents differently depending on the age of the child but these are some things to look out for:

If you have adopted an infant, pay attention if you notice that your child doesn’t smile or make eye contact, doesn’t reach out to be picked up, rejects your efforts to sooth or comfort her and doesn’t notice or care when you leave her alone. Also be aware if your child doesn’t imitate or play interactively, and if she is unresponsive to you or chooses others to hold her instead of you.

If your child is a bit older, watch out for an aversion to touch, difficulty showing affection (or choosing to give and receive affection from strangers rather than her parents), anger problems, acting younger than her age, an extreme need for control and an underdeveloped conscience.

If you believe that your child’s history makes her vulnerable to attachment problems, or you recognise any of these symptoms, don’t panic. Instead be sure to create a safe environment for her, be present and consistent, ensure that she feels loved and if necessary, get assistance from an attachment expert.

In conclusion

Despite the media hype, remember that even in fostering and adoption, attachment problems are usually manageable and chronic problems are rare. For the best chances of successful attachment, be sure to follow your social worker’s guidelines for bonding and ensure that your child gets what she needs to feel safe, secure and loved, especially during the transition to her new home. And if in doubt, seek help.

A final thought

If you are considering adopting, don’t allow fear to stop you. The challenges you envisage may never materialise and even if they do, remember that every child deserves someone who will fight for her. Most adoptive parents I speak to agree, no matter what you face, the rewards (for you and your child) definitely outweigh the risks.

With thanks to Helpguide.org for the invaluable content about Attachment Disorders.